Value of Asking About Family History of Heart Disease

Systematically asking primary care patients to report such histories substantially increased the percentage identified as having high CV risk.


Family history of premature heart disease is a recognized cardiovascular (CV) risk factor, yet data on the value of systematically asking patients about it in primary care are scant. Researchers in the U.K. randomized 24 primary care practices to either a usual-care approach, in which patients were stratified into standard Joint British Societies 2 (JBS2) categories of 10-year CV risk (average, <10%; moderate, 10%–19%; high, ?20%), or an intervention in which patients also completed questionnaires about family history of premature heart disease. If family history was positive (coronary disease in a male first-degree relative aged <55 or a female first-degree relative aged <65), JBS2 risk level was multiplied by 1.5 (a multiplier that is supported by epidemiologic data).

The analysis included 748 patients (age range, 30–65) without previously diagnosed diabetes or heart disease. The percentage of patients classified as high risk was significantly higher in the intervention group than the usual-care group (4.8% vs. 0.3%), even after adjustment for patient and practice characteristics.


Citation(s):

Qureshi N et al. Effect of adding systematic family history enquiry to cardiovascular disease risk assessment in primary care: A matched-pair, cluster randomized trial. Ann Intern Med 2012 Feb 21; 156:253.

Berg AO. Family history gets a boost. Ann Intern Med 2012 Feb 21; 156:315.